CONCERNS have been raised about “significant pressures” facing frontline staff and the impact on patient safety at a North Wales hospital.

CONCERNS have been raised about “significant pressures” facing frontline staff and the impact on patient safety at a North Wales hospital.

A report published by Healthcare Inspectorate Wales (HIW) found Ysbyty Glan Clwyd was operating at 100% bed capacity with nurses said to be under pressure.

Staffing levels were found to be affecting the flow of patients through the hospital.

And although staff were observed to be professional and care was being delivered in a compassionate way, the inspectorate heard that beds had been closed for patient safety.

Inspectors also raised concerns about staffing levels in one ward where nurses were unable to care properly for patients with complex needs.

The inspectorate was invited by Betsi Cadwaladr University Health Board to look at patient care at Glan Clwyd following an ombudsman report into a case in which a man died after receiving poor care at the Bodelwyddan hospital.

The case raised concerns in relation to nursing care, the failure of staff to recognise clinical deterioration, the lack of recognition of the end of life pathway and inadequate investigations of the concerns raised by the man’s family.

During their inspection, HIW said the health board had addressed some of the concerns raised by the ombudsman but highlighted a number of key issues in relation to the patient care.

The report said: “It was clear to us from observations and discussions that staff were feeling under pressure.

“We were also told of high sickness levels amongst some nursing teams which was resulting in high levels of bank staff being used to cover shifts, sickness and vacancies.

“We heard that beds were being closed at Glan Clwyd due to concerns about patient safety arising from low staffing levels.

“During our visit to one ward we escalated concerns to the executive director for nursing as staffing levels were insufficient to ensure appropriate levels of care given the complexity of patient being cared for on the ward.

“There were only two trained nurses and one untrained healthcare assistant on the nightshift that we observed.

“There appeared to be time lapse issues with recruitment which was putting significant pressure on the nurse bank which was unable to fulfil all the requested shifts.

“Concerns were consistently expressed to us about bed pressures, increased patient dependency and the inability to fill gaps in staffing.

“Staff highlighted to us that morale ‘was not great in some areas’ and also aired with us their frustration at being unable to provide high standard of care due to a lack of staffing.”

The report follows concerns raised by the head of the Royal College of Nursing (RCN) in Wales who warned nurses did not have time to care because of staff shortages and increased pressures on the NHS.

As reported in Monday’s Western Mail, Tina Donnelly said nurses wanted to provide high levels of care.

She said: “Nurses have told us that the system is under immense pressure and about short staffing levels.

“There needs to be a wake-up call that if you are constantly going to reduce resources in the NHS there will be an impact because nurses are not superwomen and supermen.

“It comes across as lacking compassion but what they lack is sufficient resources.”

The inspectorate’s report also found that staffing was tight for junior medics and A&E consultants, while pressures on the emergency department meant ambulances were often left queuing outside with patients being held for “significant time”.

Significant pressures were also identified on the acute care wards, however patients said staff treated them with dignity, were attentive and provided timely care.

Other issues in the report, which makes 23 recommendations, included limited communication between the out-of-hours staff and the emergency department, the state of facilities on the wards and the way the health board responded to complaints.

“However, more needs to be done to ensure that Glan Clwyd Hospital is able to cope with the demands placed upon it.

“The health board needs to work with clinicians and staff to ensure that it is able to meet these demands in a way that maintains the quality and safety of services at the hospital.”

In response, a statement from the health board said: “Since the review was undertaken, the health board has continued to work to improve the quality and safety of patient care in Ysbyty Glan Clwyd at a number of levels.

“The health board accepts the recommendations of the review and will continue to work to address the issues raised.”

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